Laparoscopic specimen removal apparatus

ABSTRACT

An improved retractable cleat device having a housing and a telescopic cleat member absent a handle. The telescopic cleat member is lockable in the housing in a retracted position via a cam channel having at least one interval engaging a cam follower. The cam channel includes at least one interval which unlocks the telescopic cleat and allows the telescopic cleat to move to an upraised position via a bias force of a compression spring.

This application claims the benefit of priority of U.S. ProvisionalApplication Serial No. 60/081,609 filed Apr. 13, 1998.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to laparoscopic instruments and, moreparticularly, to laparoscopic specimen removal apparatuses.

2. General Background

One of the biggest concerns in laparoscopic surgery is the number oflaparoscopic instruments required to perform the surgical procedure andthus the number of incisions in the patient to insert such instruments.Therefore, several attempts have been made to integrate the functions ofdifferent laparoscopic instruments in such a manner that the number ofincisions or trocar sites required to carry out the surgical procedureis minimized. However, any such integration of functions should notcomplicate the overall surgical procedure but instead simplify.

Before extracting the tissue or specimen from the patient's cavity, thetissue/specimen is placed in a receptacle such as, a bag, web or sheathto minimize further exposure of the other organs from the possiblydiseased tissue/specimen being removed. As can be surmised, the bag orreceptacle must be opened and/or deployed and, preferably, closed whilein the patient cavity.

Several laparoscopic instruments have been patented which are used toassist in tissue removal during laparoscopic surgery.

U.S. Pat. No. 5,630,822, issued to Hermann et al., discloses alaparoscopic tissue removal device which includes a grasper coaxiallymounted within an expandable sheath and including jaws for grabbing aspecimen. However, a second tool must be used to tie off the sheath.Additionally, the use of other conventional laparoscopic grasping toolsto push the mass into the flared end of the sheath is disclosed.

U.S. Pat. Nos. 5,190,555, issued to Wetter et al.; 5,336,227, issued toNakao et al.; and, 5,352,184, issued to Goldberg et al. all discloselaparoscopic tools with a bag for capturing tissue, closing the bag viaa drawstring and withdrawing it back through the tool.

U.S. Pat. Nos. 5,496,330, issued to Bates; 5,658,296, issued to Bates etal.; and, 5,197,968, issued to Clement all disclose a laparoscopic toolswhere the tool has a flexible basket for the tissue capture.

U.S. Pat. Nos. 5,176,687, issued to Hasson et al. and 5,312,417, issuedto Wilk disclose laparoscopic tools with an open ended bag to capturetissue samples. In the Hasson et al. patent ('687), though alaparoscopic removal tool can be inserted through the bag, the bag mustbe pulled down out of a sleeve and opened with the assistance of asecond tool, such as, forceps. The bag in '687 is made of a membranewhich is not rigid and has no rigid supports to allow it to open on itsown inside a patient. In the Wilk patent ('417), the receiver portion oropen ended web (bag) is provided with support means to open and expandthe open ended web (bag). Numerous proposals are suggested to open thereceiver portion or web including complicated techniques using hydraulicor pneumatic circuits. Nevertheless, the invention described in '417does not disclose any means in the laparoscopic cannula assembly whichserves to close the open end of the web (bag) and, more specifically,the support means supporting the web (bag).

U.S. Pat. Nos. 5,190,1555, 5,336,227, 5,352,184, 5,496,330, 5,312,417,5,197,968, 5,176,687; 5,630,822, 5,658,296, 5,423,830 are incorporatedherein by reference.

U.S. Pat. Nos. 5,465,731 and 5,647,372, both of which are assigned toUnited States Surgical Corporation, disclose a specimen removal pouchand applicator which includes a pouch closed via a drawstring. Anadditional forceps or grasper inserted though another cannula may beneed to unroll the pouch if necessary. The disclosed specimen removalpouch and applicator is not adapted to have a laparoscopic grasper orother laparoscopic instrument inserted coaxially through the applicator.

U.S. Pat. No. 5,480,404, issued to Kammerer et al., discloses a surgicaltissue retrieval instrument including a collapsible pouch having acinching mechanism. The instrument of Kammerer et al., like theapplicator disclosed in '731 and '372, is not adapted to have alaparoscopic grasper or other laparoscopic instrument inserted coaxiallytherethrough.

U.S. Pat. No. 5,423,830, issued to Schneebaum et al., discloses aninstrument assembly having a capture component including a web memberattached to spring biased ribs which opens into a cup-shapedconfiguration when ejected. A vacuum or suction source is provided toprovided a negative pressure to assist in clamping the web member andribs around the tissue/specimen. The instrument assembly of Schneebaumis not adapted to have the cauterization loop inserted coaxially throughthe web.

U.S. Pat. No. 5,074,867, issued to Wilk, discloses a membrane or webhaving stings or filaments attached to the periphery or corners thereof.Forceps or the like are used to stretch the membrane until it assumes asubstantially opened position which is shown as a flat sheet-likeprofile. The strings are used to surround the membrane or web around thespecimen or organ.

As can be readily seen, there is a continuing need for a laparoscopicspecimen removal apparatus including a laparoscopic specimen extractorhaving a specimen bag having support means for allowing the bag to beopened and closed without the use of a separate laparoscopic tool; and,a specimen grasper coaxially mountable within the specimen bag.

SUMMARY OF THE PRESENT INVENTION

The preferred embodiment of the laparoscopic specimen removal apparatusof the present invention solves the aforementioned problems in astraight forward and simple manner. What is provided is an apparatus forremoving specimens from a patient during laparoscopic surgery comprisinga laparoscopic specimen extractor having a specimen bag having supportmeans for allowing the bag to be opened and closed without the use of aseparate laparoscopic tool; and, a specimen grasper coaxially mountablewithin the specimen bag.

Broadly, the laparoscopic specimen extractor comprises:

-   -   (a) a bag having open ends;    -   (b) a means for supporting said bag having a plurality of tips'        wherein said support means is spring biased and uniquely        arranged to automatically open into a tulip shape when ejected        to a deployed position;    -   (c) means coupled to said plurality of tips for cinching closed        said support means; and    -   (d) a pathway, formed coaxially through said laparoscopic        specimen extractor and said support means and having said        cinching closed means journalled axially therethrough wherein        said pathway is adapted to have inserted coaxially therethrough        a grasping laparoscopic instrument for retrieving said specimen,        adapted to have retracted therethrough said grasping        laparoscopic instrument to deposit said specimen in said bag and        adapted to aspirate or morcelate said specimen in said bag        therethrough.

The support means cinches closed to a generally elliptical or footballshape.

In view of the above, it is an object of the present invention toprovide a laparoscopic specimen removal apparatus which includes alaparoscopic specimen extractor having a cage lined with a liner or bagwhich automatically expands and opens to a “tulip” shape when deployedand means secured to the cage for cinching closed distal ends or tips ofthe cage when opened.

Another object of the invention is to provide such a cage or supportmeans with a plurality of spring biased strips having tips wherein afirst set of the strip tips are tied together via a first drawstring anda second set of the strip tips are tied togther via a second drawstring.Pulling the first and second drawstrings cinches closed the tips and,thus, the liner or bag attached to the cage.

A further object of the present invention is to provide such a cage orsupport means which when closed the plurality strips are essentiallystraight, when opened forms a “tulip” shape and when cinched closedforms an “elliptical” or “football” shape.

A further object of the present invention is to provide a support meanswhich include rigid but flexible strips which are secured to the bag.

It is a still further object of the present invention to provide such alaparoscopic specimen extractor with a cinching closed means includingfirst and second drawstrings and a means for pulling the drawstringssimultaneously to cinch close the cage or support means.

It is a still further object of the present invention to provide thecage or support means with a plurality of strips wherein each strip hasa free end twisted approximately 90° (ninety degrees) with respect tothe rest of the strip to form a twisted section and a hole is bored insuch twisted section. This twisted section is substantiallyperpendicular to the center axis of inner tube assembly and thus thecage. Likewise, the center of the holes in the twisted sections issubstantially perpendicular to said center axis. Thereby, as the tips(twisted section) is cinched closed via the drawstring the twistedsection are drawing toward each other so that an “elliptical” or“football” shape is created.

In view of the above objects, it is a feature of the present inventionto provide a laparoscopic specimen extractor which is simple to use andfurther does not complicate the tissue surgical procedure but insteadsimplifies it.

Another feature of the present invention is to provide a laparoscopicspecimen extractor which is relatively simple structurally and thussimple to manufacture.

A major advantage of the laparoscopic specimen extractor it itsutilization of a unique specimen entrapment system which compresses andforms the specimen into a “dilator” or “football” shaped package inwhich its cross section's diameter is much smaller than its length. Thisaerodynamic shape has the advantage of exiting a smaller incision withsignificantly less effort than conventional bag type retrieval systemswhich form the specimen into a “spherical” or basketball” shape which isdifficult to pull through a small incision.

Another advantage of the present invention is the ability of thelaparoscopic specimen extractor, through a single site, to (1) insert agrasping laparoscopic instrument through (coaxially) the extractors'center; (2) retrieve a specimen and pull the specimen into the specimencage/bag assembly via the coaxially inserted grasping laparoscopicinstrument; (3) compress the specimen cage/bag assembly into anaerodynamic package; (4) aspirate and/or morcelate the specimen in aprotective environment; and, (5) remove the specimen from the patient'scavity.

The above and other objects, features and advantages of the presentinvention will become apparent from the drawings, the description givenherein, and the appended claims.

BRIEF DESCRIPTION OF THE DRAWING

For a further understanding of the nature and objects of the presentinvention, reference should be had to the following description taken inconjunction with the accompanying drawings in which like parts are givenlike reference numerals and, wherein:

FIG. 1 illustrates a cross-sectional view of the laparoscopic specimenextractor of the present invention with the cage/bag assembly in theretracted position;

FIG. 2 illustrates a cross-sectional view of the laparoscopic specimenremoval apparatus of the present invention with the cage/bag assembly inthe open deployed position;

FIG. 3 illustrates a cross-sectional view of the laparoscopic specimenremoval apparatus of the present invention with the cage/bag assembly inthe closed position;

FIG. 4 illustrates a partial perspective view of the spring loadedstrips in an open position;

FIG. 5 illustrates a top view of the bag retaining collar;

FIG. 6 illustrate a first alternate embodiment of the laparoscopicspecimen removal apparatus of the present invention with the cage/bagassembly in the open deployed position;

FIG. 7 illustrates the first alternate embodiment of the laparoscopicspecimen removal apparatus of the present invention with the cage/bagassembly in the closed position;

FIG. 8 illustrates a top view of the drawstring handle assembly of FIG.6;

FIG. 9 illustrates an alternate embodiment of the drawstring handleassembly;

FIG. 10 illustrates a perspective view of a second alternate embodimentof the laparoscopic specimen extractor of the present invention with thecage/bag assembly in the deployed position;

FIG. 11 illustrates an exploded perspective view of a fourth alternateembodiment of the laparoscopic specimen removal apparatus of the presentinvention with the cage/bag assembly in the deployed position;

FIG. 12 illustrates a perspective view of a fifth alternate embodimentof the laparoscopic specimen removal apparatus of the present inventionwith the specimen cage/bag assembly closed in the substantially“elliptical” or “football” shape; and,

FIG. 13 illustrates the twisted end section of a respective springloaded strip.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

FIGS. 2 and 3 illustrates a cross-sectional view of the laparoscopicspecimen removal apparatus 100 of the present invention with thecage/bag assembly 15 in the open deployed position. The laparoscopicspecimen removal apparatus 100 includes in general laparoscopic specimenextractor 10 and grasping laparoscopic instrument 80.

FIG. 1 is a cross-sectional view showing the laparoscopic specimenextractor 10 with the specimen cage/bag assembly 15 in a retractedposition. The laparoscopic specimen extractor apparatus 10 is alaparoscopic device used to facilitate the removal of a specimen 30 froma patient's cavity through a trocar or trocar site. The laparoscopicspecimen extractor 10 basically has a tube inside a tube design.

The laparoscopic specimen extractor 10 in general comprises a specimencage/bag assembly 15, an outer tube assembly 40, serving as thecontainer for the specimen cage/bag assembly 15, and an inner tubeassembly 50 which is slidably coupled in the outer tube assembly 40 andhas the specimen cage/bag assembly 15 on its patient end.

The outer tube assembly 40 is fabricated of surgical-grade stainlesssteel or any other biocompatible material having a diameter of 10 mmwith a wall thickness of approximately 0.25 mm. A collar 60, made of thesame material as the outer tube assembly 40, is 13 mm in diameter and 10mm long with a wall thickness of approximately 1.5 mm. The collar 60 isaxially fused to the operator end of the outer tube assembly 40. Thecollar 60 has a groove approximately 1 mm wide cut into the innercircumference, positioned 1.5 mm from the open end of the collar 60.Such groove accommodates a 9.5 mm surgical grade O-ring 65 whichprovides an air-tight seal with the inner tube assembly 50.

A finger ring assembly 70, made of surgical-grade stainless steel, orany other biocompatible material, is mounted at the collar end or, inother words, the operator end, of the outer tube assembly 40,surrounding the collar 60. The finger ring assembly 70 contains two (2)rings 71 oriented across from each other, resembling finger holes of alarge syringe. The rings 71 have approximately a 15 mm inner diameterand a 3 mm ring thickness or width and are positioned approximately 20mm from the collar end of the tube assembly 40 to the ring's centers.The total length of the outer tube assembly 40 is approximately 200 mm.

The inner tube assembly 50 is fabricated of surgical grade stainlessseel or any other biocompatible material. The inner tube assembly 50 hasan outer diameter of 9.5 mm with a wall thickness of approximately 0.25mm and a length of 200 mm. The inner tube assembly 50 has externalthreads (not shown), on the operator end, 8 mm long with an outerdiameter of approximately 11 mm. An internally threaded end cap 74,which has an integrated thumb cradle 72, is threaded onto the operatorend of the inner tube assembly 50.

Referring also to FIGS. 2 and 3, a 6 mm hole 75 is bored through thecenter of the end cap 74, as best seen in FIG. 1, to accommodate thegrasping laparoscopic instrument 80. The grasping laparoscopicinstrument 80 is to be coaxially inserted through the center of thumbcradle 72 down through the inner tube assembly 50. Two (2) small holes76, approximately 0.5 mm, are bored into the side of the end cap 74 toallow a passage for two (2) drawstrings 28 and 38 which are tied to ring29. A seal (not shown) fabricated of surgical grade silicone or anyother medical grade flexible material which has a diameter of 10 mm anda thickness of 0.20 mm with a 5 mm flexible hole in the center alignedwith the hole 75 in the end cap 74 is installed between the operator endand the underside surface of the end cap 74. This seal prevents gas fromleaking around the laparoscopic instrument 80 when inserted. A plug (notshown), which is 10 mm long having an outer diameter of 6 mm fabricatedof medical grade silicone, is used to plug the hole 75 in the end cap 74and, when not in use, is tethered from the end cap 74. This plugprevents gas from leaking from the patient to atmosphere beforeinsertion of extractor 10.

Referring now to FIGS. 6 and 7, an alternate embodiment of thelaparoscopic specimen removal apparatus 100′ is shown. The primarydifference is that in lieu of ring 29 and integrating the thumb cradle72 with end cap 74, a drawstring handle assembly 90 is substituted. Thedrawstring handle assembly 90 includes internally threaded end cap 74′which is threaded onto the operator end of inner tube assembly 50 and arod or handle 91 which is integrated with the end cap 74′ to radiallyproject from the outer circumferential surface of end cap 74′ atapproximately 45° (forty-five degrees). The draw drawstring handleassembly 90 further includes a palm rest 92 affixed to the free end ofthe rod or handle 91 and a sliding finger squeeze slide 93.

Like end cap 74, end cap 74′ is provided with a bored hole 75′, for theinsertion of the laparoscopic instrument 80 and the bored side holes 76′(only one shown) for the passage of the two (2) drawstrings 28 and 38.The free ends of the draw strings 28 and 38 are affixed or tied to thesliding finger squeeze slide 93 slidably mounted on rod or handle 91. Inthe exemplary embodiment, when the operator squeezes the fingers onfinger squeeze slide 93, sliding finger squeeze slide 93 slides upwardtoward palm rest 92 thereby simultaneously pulling drawstrings 28 and 38to cinch close cage 20.

Referring now to FIG. 9, in lieu of the drawstring handle assembly 90,drawstring hand assembly 90′ is substituted. The drawstring handleassembly 90′ includes internally threaded end cap 74″ which is threadedonto the operator end of inner tube assembly 50 and a rod or handle 91′which is integrated with the end cap 74′ to radially project from theouter circumferential surface of end cap 74′. The draw drawstring handleassembly 90′ further includes a palm rest 92′ affixed to the free end ofthe rod or handle 91′ and a sliding finger squeeze slide 93′. In thisembodiment, palm rest 92′ and squeeze slide 93′ have an enlarged surfacearea. Locking means 99 holds slide 93′ in the “up” position of FIG. 12,by frictional engagement (it binds itself) and attachment to slide 93′and can be released by movement toward slide 93′.

Like end cap 74′, end cap 74″ is provided with a bored hole 75″, for theinsertion of the laparoscopic instrument 80 and the bored side holes 76″for the passage of the two (2) drawstrings 28 and 38. The free ends ofthe draw strings 28 and 38 are affixed or tied to the sliding fingersqueeze slide 93′ slidably mounted on rod or handle 91′ via holes 93a′and 93b′. Longitudinal bore holes 93a′ and 93b′ are position in closeproximity to the outer perimeter edge of squeeze slide 93′ so theoperator's fingers can be positioned on the underside of squeeze slide93′ between the drawstrings 28 and 38 and rod or handle 91′.

Referring now to FIG. 10, a perspective view of an alternate embodimentof the laparoscopic specimen extractor 10′ is shown. The primarydifference between the laparoscopic specimen extractor 10′ and thelaparoscopic specimen extractor 10 of FIG. 1 is that the bored sideholes 76 of FIG. 1 for the passage of the two (2) drawstrings 28 and 38have been moved to a position adjacent the hole 75 formed in the end cap74. Thereby, the drawstrings 28 and 38 exit the rear end of the end cap74 and not through the side. Additionally, the finger rings 71′ differfrom the finger rings 71 in that finger rings 71′ are squared in steadof circular.

The squared finger rings 71′ are integrated with jacket 79 having abored hole therethrough. The operator end of the outer tube assembly 40has affixed thereto jacket 79 such that jacket 79 is stationary.

Referring now to FIGS. 11 and 12, an alternate embodiment of thelaparoscopic specimen removal apparatus 100″ is shown. The primarydifference is that in lieu of the thumb cradle 72 of FIG. 10, thedrawstring handle assembly of FIG. 9 has been substituted. Furthermore,instead of affixing rod or handle 91′ 90° (ninety degrees) with respectto the circumferential surface of end cap 74″, rod or handle 91′ isangled approximately 45° (forty-five degrees). FIG. 11 illustratescage/bag assembly 15 of the laparoscopic specimen removal apparatus 100″deployed and in the open position. FIG. 12 illustrates cage/bag assembly15 of the laparoscopic specimen removal apparatus 100″ deployed and inthe cinched closed position.

Since the cage/bag assembly 15 of FIGS. 1-7 and 10-12 are essentiallythe same, the cage/bag assembly 15 shown in FIGS. 1-4 will be describedherein in detail. At the patient end of inner tube assembly 50, six (6)spring loaded strips 21, 22, 23, 24, 25 and 26, fabricated of medicalgrad material approximately 120 mm long and 3 mm wide with a thicknessof 0.40 mm, are mounted in a circular fashion spaced 60° (sixty degrees)apart to the inner circumference of the inner tube assembly 50. Thesespring loaded strips 21-26 are recessed approximately 15 mm inside ofthe inner tube assembly 50 and protrude out of the end of the inner tubeassembly 50 approximately 105 mm. The protruding portion of the springloaded strips 21-26 are curved outward approximately 20 mm from thetube's axis in an arc fashion, when in the retracted position, as bestseen in FIGS. 2 and 4. The six (6) spring loaded strips 21-26 protrudingfrom the inner tube assembly 50 are capable of forming a shape thatresembles a “tulip”, as best seen in FIGS. 2 and 4, when in a retractedposition. This structure forms the specimen cage 20 or support meanswhich supports the specimen liner or bag 32. Although six (6) strips21-26 are shown, more or fewer strips could be used.

Since the spring loaded strips 21-26 protrude out of the end of theinner tube assembly 50 approximately 105 mm, the total length of thespring loaded strips 21-26 forming the cage 20 or support means ejectedfrom the patient end of outer tube assembly 40 may be varied inaccordance with the size of the specimen 30. Moreover, as the totallength of the spring loaded strips is varied, the amount of expansion orflaring of these spring biased strips 21-26 is varied proportionally.

Referring also to FIG. 13, since each of the spring loaded strips 21-26are essentially identical, only one such strip will be described indetail. On the unattached end, tip or free end of spring loaded strip21, 7 mm of said unattached end is twisted at 90° (ninety degrees) withrespect to the rest of the strip 21 thus forming a twisted end section21a. A 0.5 mm hole 27 is bored in this twisted end section 21a 1.5 mmfrom the distal end thereof. The hole 27 accommodates one of two (2)drawstrings 28 and 38. This twisted section 21a is substantiallyperpendicular to the center axis of inner tube assembly 50 and thus thecage 20. Likewise, the center of the hole 27 in the twisted section 21ais substantially perpendicular to said center axis. Thereby, as the tips(twisted section 21a) is cinched closed via the drawstrings 28 and 38.The twisted sections of all the spring loaded strips 21-26 are drawntoward each other so that they are closely circumferentially stackedclosely one after the other. Thereby, an “elliptical” or “football”shape is created. Moreover, holes 27 in each of the twisted sectionsprovide a circumferential passageway for drawstrings 28 and 38 whereinthe center of the circumferential passageway is perpendicular to thecenter axis of cage 20 and inner tube assembly 50.

Referring also to FIG. 5, the spring loaded strips 21-26 are held inplace with an internal retaining collar 33 with an outer diameter ofapproximately 7.5 mm, a length of 15 mm and a 5 mm axially bored holethrough the center to allow for the passage of laparoscopic instruments,such as, grasping laparoscopic instrument 80, therethrough. Also, two(2) holes 34 approximately 0.15 mm in diameter are bored to accommodatethe two (2) drawstrings 28 and 38, respectively, therethrough. Thecollar 33 is fabricated from a medical grade stainless steel or anyother biocompatible material and is positioned approximately 7 mm fromthe patient end of the inner tube assembly 50. The spring loaded stripsare numbered in a clockwise manner 21, 22, 23, 24, 25 and 26 with 21being adjacent 26.

The drawstring 28, which is 400 mm long and made of #0 silk suture orany biocompatible ligature, is tied with an appropriate knot through thehole 27 of strip 21; the other end is passed or threaded through thehole 27 in the strips 22, 23 and 24 making a 90° (ninety degree) turnrunning parallel along the top of strip 24, through one of the holes 34in the retaining collar 33, through the center of the inner tubeassembly 50, and exiting through one of the holes 76 or 76′ in the endcap 74 or 74′. The end of drawstring 28 is tied off to a ring 29 or anyapproximate handle assembly 90 or 90′, in the manner as described above.When the drawstring 28 is pulled, strips 21, 22, 23 and 24 will be drawntogether. More specifically, the ends or tips of spring loaded strips21-24 are drawn together.

A second drawstring 38, which is 400 mm long and, likewise, made of #0silk suture or any biocompatible ligature, is tied with an appropriateknot through the hole 27 of strip 24; the other end is passed throughthe hole 27 in strips 25, 26 and 21 making a 90° (ninety degree) turnrunning parallel along the top of the strip 21, through the other one ofholes 34 in the retaining collar 33, through the center of the innertube assembly 50, exiting through the other one of holes 76 or 76′ inthe end cap 74 or 74′. The end of drawstring 38 is tied off to the samering 29 or any appropriate handle assembly 90 or 90′, as is the otherdrawstring 28. When the drawstring 38 is pulled, the strips 24, 25, 26and 21 will be drawn togther. More specifically, the ends or tips ofspring loaded strips 21 and 24-26 are drawn together.

When both drawstrings 28 and 38 are pulled simultaneously all the endsor tips of the six (6) spring loaded strips 21-26 will be drawntogether, thus forming a substantially “elliptically” or “football”shaped cage 20 or support means, as best seen in FIG. 3, trapping thespecimen 30 inside. As the ends or tips of the spring loaded strips21-26 are drawn together the cage 20 or support means forms a “dilator”or “football” shaped package in which its cross section's diameter ismuch smaller than its length. This aerodynamic shape has the advantageof exiting a smaller incision with significantly less effort thanconventional bag type retrieval systems which form the specimen into a“spherical” or “basketball” shape which is difficult to pull through asmall incision.

A cylindrical liner or bag 32 made of surgical grade plastic, such asthe material found in U.S. Surgical's Endo Catch, would be suitable forthis application and is positioned inside the spring loaded strips 21-26and hemmed around the drawstrings 28 and 38 and the strip ends or tips.The other end of the cylindrical liner or bag 32 is secured to the innercircumferential wall of the patient end of the inner tube assembly 50and is held in place by a medical grade bag retaining ring 35. The bagretaining ring 35, having an opening of 6 mm, is positioned in front ofthe internal retaining collar 33. This liner or bag 32 prevents leakageof specimen fluids during extraction.

All of the above individual measurements and dimensions could be reducedby 99.999% or enlarged by 10,000% to fit a specific application.

The laparoscopic specimen extractor 10 is assembled by inserting theinner rube assembly 50 inside the outer tube assembly 40 through theoperator end.

The inner tube assembly 50 has two (2) positions, retracted (FIG. 1) anddeployed (FIG. 2). In the deployed position, preferably, the patient endof the inner tube assembly 50 is even with the patient end of the outertube assembly 40, allowing the specimen cage/bag assembly 15 protrudingfrom the patient end of inner tube assembly 50 to be exposed and opened,as best seen in FIG. 2. In the retracted position, the inner tubeassembly 50 is pulled back approximately 105 mm, causing the cage 20 orsupport means and the liner 32 to collapse and be contained within outertube assembly 40, as best seen in FIG. 1.

The operation of the laparoscopic specimen extraction 10 of thelaparoscopic specimen removal apparatus 100 is described below. Thelaparoscopic specimen extractor 10 is inserted, patient-end first, intoa trocar or open incision in the retracted position, as best seen inFIG. 1. The laparoscopic specimen extractor 10 is then deployed byinserting two (2) fingers in the finger rings 71 on the outer tubeassembly 40 and placing the thumb in the thumb cradle 72 on the end cap74. The operator slowly squeezes his thumb and fingers together, pushingthe inner tube assembly 50 in the outer tube assembly 40 until thespecimen cage/bag assembly 15 is fully exposed, as best seen in FIG. 2.

The operator then removes said plug (not shown) in end cap 74 of theinner tube assembly 50 and inserts the grasping instrument 80 throughthe hole 75, through the center of the inner tube assembly 50 and thespecimen cage/bag assembly 15, and grasps the specimen 30, as best seenin FIG. 2. The operator then pulls the specimen 30 into the cage/bagassembly 15, as far as possible, by retracting grasping laparoscopicinstrument 80, as best seen in FIG. 3. After the specimen 30 is placedin the cage/bag assembly 15, the operator pulls the drawstrings 28 and38 via ring 29 causing the end or tips of the specimen cage 20 orsupport means and, thus, liner 32 to be cinched closed, trapping thespecimen 30 inside. After the specimen 30 has been placed in thecage/bag assembly 15, the grasping laparoscopic instrument 80 should bemanipulated to release or deposit the specimen 30 in the cage/bagassembly 15 before fully retracting the grasping laparoscopic instrument80.

The grasping instrument 80 can then be removed from the inner tubeassembly 50 by fully retracting the grasping instrument 80 from theinner tube assembly 50 and an aspirator or morcelator may be inserted toremove tissue and fluids to further reduce the size of the specimen 30.The operator then extracts the laparoscopic specimen extractor 10through the trocar or open site.

From the forgoing, it can be readily seen that an advantage of thelaparoscopic specimen extractor 10 is its ability, through a singlesite, to (1) insert a grasping laparoscopic instrument 80 through(coaxially) the extractors' center; (2) retrieve a specimen 30 and pullthe specimen 30 into the specimen cage/bag assembly 15 via the coaxiallyinserted grasping laparoscopic instrument 80; (3) compress the specimencage/bag assembly 15 into an aerodynamic package; (4) aspirate and/ormorcelate the specimen 30 in a protective environment; and, (5) removethe specimen 30 from the patient's cavity.

Referring now to the operation of the embodiment shown in FIGS. 6 and 7,in lieu of squeezing the thumb cradle 72 and finger rings 71 together todeploy the laparoscopic specimen extractor 10, the handle assembly 90and finger rings 71′ of the laparoscopic specimen extractor 10′ aresqueezed together. For example, the thumb may be placed over the end cap74′ and the fingers in the finger rings 71′. Thereafter, the operatorslowly squeezes the thumb on the end cap 74′ and the fingers in thefinger rings 71′ together.

The operation of the laparoscopic specimen extraction the laparoscopicspecimen removal apparatus 100′ (FIG. 10) and 100″ (FIGS. 11-12) isessentially the same as that which has bee described above with respectto FIGS. 1-7.

Because many varying and differing embodiments may be made within thescope of the inventive concept herein taught and because manymodifications may be made in the embodiment herein detailed inaccordance with the descriptive requirement of the law, it is to beunderstood that the details herein are to be interpreted as illustrativeand not in a limiting sense.

1. A laparoscopic specimen extractor comprising: (a) an outer tubeassembly insertable in an incision or trocar; (b) an inner tube assemblyslidably mounted coaxially in said outer tube to slide between aretracted position to a deployed position and having an operator end anda patient end; (c) a cage having one end securely coupled to saidpatient end and a free end wherein, when said inner tube assembly is insaid retracted position, said cage is collapsed and contained in saidouter tube assembly and, when said inner tube assembly is in saiddeployed position, said cage is at least partially ejected from saidouter tube assembly and said free end automatically opened and expandedinto a tulip shape, said cage comprising a plurality of spaced springloaded strips secured to the inner circumferential wall of said patientend of said inner tube assembly and which project from said patient endwherein said free end of said cage comprises tips of said plurality ofspaced spring loaded strips, each strip having a free end twistedapproximately 90° (ninety degrees) with respect to the rest of itself toform a twisted section and a hole is bored in such twisted sectionwherein said twisted section is substantially perpendicular to a centeraxis of said inner tube assembly and said cage and wherein as thetwisted sections are cinched closed, said cage forms a substantiallyelliptical or football shape; (d) means journalled through said innertube assembly and secured to said free end of said cage for cinchingclosed said free end; and, (e) a pathway coaxially through said innertube assembly and said cage and adapted to have journalled therethroughsaid cinching close means, adapted to have inserted coaxiallytherethrough a grasping laparoscopic instrument for retrieving aspecimen, adapted to have retracted therethrough said graspinglaparoscopic instrument to deposit said specimen in said cage andadapted to aspirate or morcelate said specimen in said cagetherethrough.
 2. The extractor of claim 1, wherein said cage is linedwith a liner or bag.
 3. The extractor of claim 1, wherein said outertube assembly includes a patient end and an operator end, and first andsecond finger rings oriented across from each other at said operator endof said outer tube assembly.
 4. The extractor of claim 1, wherein saidinner tube assembly comprises: an end cap coupled to said operator endof said inner tube assembly; a thumb cradle integrated with said endcap; a center hole formed in said end cap to permit coaxial insertion ofsaid laparoscopic instrument; and, an auxiliary hole formed in said endcap for passage of said cinching closed means journalled through saidinner tube assembly.
 5. The extractor of claim 4, wherein said cinchingclosed means comprises: a first drawstring coupled to said tips of afirst set of spring loaded strips of said plurality of spring loadedstrips and journalled through said inner tube assembly; a seconddrawstring coupled to said tips of a second set of spring loaded stripsof said plurality of spring loaded strips and journalled through saidinner tube assembly; and, means coupled to said first and seconddrawstrings for pulling said first and second drawstrings to cinchclose, simultaneously, said tips of said first set of spring loadedstrips and said tips of said second set of spring loaded strips.
 6. Theextractor of claim 5, wherein said pulling means comprises a ring. 7.The extractor of claim 5, wherein said inner tube assembly comprises: anend cap coupled to said operator end of said inner tube assembly; acenter hole formed in said end cap to permit coaxial insertion of saidlaparoscopic instrument; an auxiliary hole formed in said end cap forpassage of said first and second drawstrings journalled through saidinner tube assembly; and, wherein said pulling means comprises adrawstring handle assembly including: a rod having one end secured to anouter wall of said end cap and projecting therefrom; a palm restintegrated with a distal end of said rod; and, a finger squeeze slideslidably mounted on said rod and having secured thereto said first andsecond drawstrings wherein squeezing said palm rest and said fingersqueeze slide slides said finger squeeze slide upward to said palm restthus pulling said first and second drawstrings, simultaneously.
 8. Alaparoscopic specimen removal apparatus comprising: (a) a graspinglaparoscopic instrument for retrieving a specimen; and, (b) alaparoscopic specimen extractor comprising: (i) an outer tube assemblyinsertable in an incision or trocar, (ii) an inner tube assemblyslidably mounted coaxially in said outer tube to slide between aretracted position to a deployed position and having an operator end anda patient end, (iii) a cage having one end securely coupled to saidpatient end and a free end wherein, when said inner tube assembly is insaid retracted position, said cage is collapsed and contained in saidouter tube assembly and, when said inner tube assembly is in saiddeployed position, said cage is at least partially ejected from saidouter tube assembly and said free end automatically opened and expandedinto a tulip shape, said cage comprising a plurality of spaced springloaded strips secured to the inner circumferential wall of said patientend of said inner tube assembly and which project from said patient endwherein said free end of said cage comprises tips of said plurality ofspaced spring loaded strips, each strip having a free end twistedapproximately 90° (ninety degrees) with respect to the rest of itself toform a twisted section and a hole is bored in such twisted sectionwherein said twisted section is substantially perpendicular to a centeraxis of said inner tube assembly and said cage; (iv) means journalledthrough said inner tube assembly and secured to said free end of saidcage for cinching closed said free end, and, (v) a pathway coaxiallythrough said inner tube assembly and said cage and adapted to haveinserted coaxially therethrough said grasping laparoscopic instrumentfor retrieving said specimen, adapted to have retracted therethroughsaid grasping laparoscopic instrument to deposit said specimen in saidcage and adapted to aspirate or morcelate said specimen in said cagetherethrough.
 9. The apparatus of claim 8, wherein said cage is linedwith a liner or bag.
 10. The apparatus of claim 8, wherein said outertube assembly includes a patient end and an operator end, and first andsecond finger rings oriented across from each other at said operator endof said outer tube assembly.
 11. The apparatus of claim 8, wherein saidinner tube assembly comprises: an end cap coupled to said operator endof said inner tube assembly; a thumb cradle integrated with said endcap; a center hole formed in said end cap to permit coaxial insertion ofsaid laparoscopic instrument; and, an auxiliary hole formed in said endcap for passage of said cinching closed means journalled through saidinner tube assembly.
 12. The apparatus of claim 11, wherein saidcinching closed means comprises: a first drawstring coupled to said tipsof a first set of spring loaded strips of said plurality of springloaded strips and journalled through said inner tube assembly; a seconddrawstring coupled to said tips of a second set of spring loaded stripsof said plurality of spring loaded strips and journalled through saidinner tube assembly; and, means coupled to said first and seconddrawstrings for pulling said first and second drawstrings to cinchclose, simultaneously, said tips of said first set of spring loadedstrips and said tips of said second set of spring loaded strips.
 13. Theapparatus of claim 12, wherein said pulling means comprises a ring. 14.The apparatus of claim 12, wherein said inner tube assembly comprises:an end cap coupled to said operator end of said inner tube assembly; acenter hole formed in said end cap to permit coaxial insertion of saidlaparoscopic instrument; an auxiliary hole formed in said end cap forpassage of said first and second drawstrings journalled through saidinner tube assembly; and, wherein said pulling means comprises adrawstring handle assembly including: a rod having one end secured to anouter wall of said end cap and projecting therefrom; a palm restintegrated with a distal end of said rod; and, a finger squeeze slideslidably mounted on said rod and having secured thereto said first andsecond drawstrings wherein squeezing said palm rest and said fingersqueeze slide slides said finger squeeze slide upward to said palm restthus pulling said first and second drawstrings, simultaneously.
 15. Alaparoscopic specimen extractor comprising: (a) a bag having open ends,(b) a means for supporting said bag comprising a plurality of spacedspring loaded strips secured to the inner circumferential wall said bagand which project from one end of said bag, said strips having aplurality of tips wherein said support means is spring biased andarranged to automatically open into a tulip shape when ejected to adeployed position, each of said strips having a free end twistedapproximately 90° (ninety degrees) with respect to the rest of itself toform a twisted section and a hole is bored in such twisted sectionwherein said twisted section is substantially perpendicular to a centeraxis of said deployed bag; (c) means coupled to said plurality of tipsfor cinching closed said support means, and (d) a pathway, formedcoaxially through said laparoscopic specimen extractor and said supportmeans and having said cinching closed means journalled axiallytherethrough wherein said pathway is adapted to have inserted coaxiallytherethrough a grasping laparoscopic instrument for retrieving saidspecimen, adapted to have retracted therethrough said graspinglaparoscopic instrument to deposit said specimen in said bag and adaptedto aspirate or morcelate said specimen in said bag therethrough.
 16. Theextractor apparatus of claim 15, wherein said support means cinchesclosed to a generally elliptical or football shape.
 17. A specimenextractor comprising: (a) an outer assembly having an operator end and apatient end; (b) an inner assembly having an operator end and a patientend, the inner assembly being slidably mounted with respect to the outerassembly and slidable between a retracted position and a deployedposition; (c) a cage coupled to the patient end of the inner assemblyand having open and closed states, the cage comprising a base and aplurality of biased strips with tips which project from the patient endof the outer assembly when the inner assembly is placed in a deployedposition; (d) an actuator operatively connected to the cage, theactuator being able to change the state of the cage from open to closedby cinching closed the tips of the strips, wherein the actuator includesa first string connected to one or more of the tips and a second stringattached to other of the tips; and (e) wherein the cage is moved fromopen to closed when both the first and second strings are pulled,forming an elliptical shape.
 18. The specimen extractor of claim 17,wherein the number of strips operatively connected to the plurality ofstrings is an even number and each string is connected to less than thetotal number of strips.
 19. The specimen extractor of claim 17, whereineach string is operatively connected to at least two of the same tips ofthe strips.
 20. A specimen extractor comprising: (a) an outer assemblyhaving an operator end and a patient end; (b) an inner assembly havingan operator end and a patient end, the inner assembly being slidablymounted with respect to the outer assembly and slidable between aretracted position and a deployed position; (c) a cage coupled to thepatient end of the inner assembly and having open and closed states, thecage comprising a base and a plurality of biased strips with tips whichproject from the patient end of the outer assembly when the innerassembly is placed in a deployed position; and (d) an actuatoroperatively connected to the cage, the actuator being able to change thestate of the cage from open to closed by cinching closed the tips of thestrips, wherein when the cage is in an open state the cage has a tulipshape.
 21. A specimen extractor comprising: (a) an outer assembly havingan operator end and a patient end; (b) an inner assembly having anoperator end and a patient end, the inner assembly being slidablymounted with respect to the outer assembly and slidable between aretracted position and a deployed position; (c) a cage coupled to thepatient end of the inner assembly and having open and closed states, thecage comprising a base and a plurality of biased strips with tips whichproject from the patient end of the outer assembly when the innerassembly is placed in a deployed position; (d) an actuator operativelyconnected to the cage, the actuator being able to change the state ofthe cage from open to closed by cinching closed the tips of the strips,wherein when the cage is in a closed state and contains a specimen to beextracted the cage forms a substantially elliptical or football shape;and (e) the actuator comprising a plurality of drawstrings, wherein afirst drawstring cinches closed a first plurality of said tips and asecond drawstring cinches closed a second plurality of said tips.
 22. Aspecimen extractor comprising: (a) an outer assembly having an operatorend and a patient end; (b) an inner assembly having an operator end anda patient end, the inner assembly being slidably mounted with respect tothe outer assembly and slidable between a retracted position and adeployed position; (c) a cage coupled to the patient end of the innerassembly and having open and closed states, the cage comprising a baseand a plurality of biased strips with tips which project from thepatient end of the outer assembly when the inner assembly is placed in adeployed position; (d) an actuator operatively connected to the cage,the actuator being able to change the state of the cage from open toclosed, generally elliptical shape by cinching closed the tips of thestrips, wherein the cage has a liner; and (e) the actuator comprising aplurality of drawstrings, wherein a first drawstring cinches closed afirst plurality of said tips and a second drawstring cinches closed asecond plurality of said tips.
 23. A specimen extractor comprising: (a)an outer assembly having a first end and a second end; (b) an innerassembly having a first end and a second end, the inner assembly beingslidably mounted with respect to the outer assembly and slidable betweena retracted position and a deployed position; (c) a cage coupled to thesecond end of the inner assembly, the cage comprising a base, a frontend, and a plurality of biased strips, the front end including anopening, and the cage having three states including a closed state whenthe inner assembly is in a retracted position, an open state when innerassembly is in a deployed position, and a cinched closed state when theinner assembly is in a deployed position and the cage is cinched closed,wherein the opening of the front end increases in size from cinchedclose, to closed, and then to open states; (d) an actuator operativelyconnected to the cage, the actuator being able to change the state ofthe cage from the open state to the cinched closed state; and (e) theactuator including multiple drawstrings that engage the plurality ofbiased strips, one drawstring engaging at least a first of said stripsand a second drawstring that engages at least a second of said strips.24. The specimen extractor of claim 23, wherein the plurality of stripshave a plurality of tips, and wherein the actuator includes a pluralityof strings operatively connected to the plurality of tips of the strips.25. The specimen extractor of claim 24, wherein the number of stripsoperatively connected to the plurality of strings is an even number andeach string is connected to less than the total number of strips. 26.The specimen extractor of claim 24, wherein each string is operativelyconnected to at least two of the same tips of the strips.
 27. Thespecimen extractor of claim 23, wherein when the cage is in an openstate the cage has a tulip shape.
 28. The specimen extractor of claim23, wherein when the cage is in a cinched closed state and contains aspecimen to be extracted the cage forms a substantially elliptical orfootball shape.
 29. The specimen extractor of claim 23, wherein the cagehas a liner.
 30. A specimen extractor comprising: (a) an outer assemblyhaving a proximal operator end, a distal patient end and an open endedbore; (b) an inner assembly having a proximal operator end and a distalpatient end, the inner assembly being slidably mounted in the bore ofthe outer assembly and being slidable relative to the outer assembly;(c) a cage coupled to the patient end of the inner assembly, the cagecomprising a base and a plurality of biased strips with tips thatproject distally from the patient end of the inner assembly; (d) anactuator that moves the cage, wherein the actuator includes a pluralityof strings that are connected to the plurality of tips of the strips,wherein one string attaches to at least a first one of the tips and asecond string attaches to at least a second one of the strips; (e)wherein the cage can be moved into a collapsed position by pulling thecage into the bore of the outer assembly, moving the inner assembly andcage relative to the outer assembly proximally; (f) wherein the cage canbe moved to a deployed position that enables intake of a specimen to beextracted by moving the inner assembly and cage distally until the cageis positioned distally of the patient end of the outer assembly; and (g)wherein in the deployed position, the cage is biased to open distallyand can be closed to an elliptical shape after intake of a specimen bypulling the multiple strings proximally.
 31. The specimen extractor ofclaim 30, wherein the number of strips operatively connected to theplurality of strings is an even number and each string is connected toless than the total number of strips.
 32. The specimen extractor ofclaim 30, wherein each string is operatively connected to at least twoof the same tips of the strips.
 33. A specimen extractor comprising: (a)an outer assembly having a proximal operator end, a distal patient end,and an outer assembly bore; (b) an inner assembly having a proximaloperator end and a distal patient end, the inner assembly being slidablymounted in the outer assembly bore and with respect to the outerassembly; (c) a cage coupled to the patient end of the inner assembly,the cage having collapsed, open and closed states, the cage comprising abase and a plurality of biased strips with tips which project distallyfrom the patient end of the inner assembly; (d) the cage being movablebetween collapsed and open positions by moving the inner assembly andcage from a position within the outer assembly bore to a position thatspaces the cage distally of the outer assembly bore; (e) an actuatoroperatively connected to the cage and including multiplecircumferentially spaced drawstrings, each drawstring being connected toa different plurality of the tips, the actuator enabling a change of thestate of the cage from open to closed by cinching closed the tips of thestrips when the cage is positioned distally of the outer assembly bore;(f) wherein when the cage is in an open position, the cage has a taperedshape that gradually increases in diameter distally, enabling intake ina distal to proximal direction of a specimen to be extracted; and (g) agrasping instrument that has operator and patient ends, that graspinginstrument being extendable through the inner assembly and cage, thepatient end of the grasping instrument having a tool for enablingextraction of a specimen.